Study says HPV vaccine best suited for teens

Cost-effectiveness highest for preteens, researchers find

An expensive vaccine aimed at preventing cervical cancer makes sense for young teens when it comes to cost-effectiveness, but not for women in their 20s, contends a new report.

The vaccine against the HPV virus was licensed in 2006 for use in girls and women ages 9 to 26. Health officials recommend it for girls at age 11 or 12, and some doctors offer it to women in their 20s in "catch-up" campaigns.

The maker of the Gardasil vaccine, Merck & Co., also wants to market it to women ages 27 to 45, but so far the U.S. Food and Drug Administration has denied that request.

The government-funded study found the HPV vaccine is very cost-effective when given to girls at age 12, but raises questions about vaccinating adults.

Gardasil is given in three doses over six months and costs about $375. It targets the two types of HPV, or human papillomavirus, believed to be responsible for about 70 percent of cervical cancer cases, and two other types that cause most genital warts. The virus spreads through sex.

Health officials say it's best to give the shots at age 11 or 12, before girls begin having sex. Some parents think that is too young.

But that is when the shots make the most economic sense, the researchers found.

They used computer models to predict the health outcomes of girls and women who get the vaccination as well as screenings, which are still recommended for recipients. Their calculation included the cost of the vaccine, screenings and treating cervical cancer and other illnesses targeted by the vaccine.

To determine cost-effectiveness, the researchers used widely accepted economic measures of how much society is willing to pay to extend the life of a person by a year. They set a figure of $43,600 per year for the Gardasil vaccination of each 12-year-old girl, well below the $100,000 mark seen as an upper range for cost-effectiveness.

That assumes the vaccine gives lifetime protection - something doctors don't know is true, because the shot is too new.

The figure would rise if a booster shot is needed, but would still be under the cost-effective threshold, experts said. Costs could also rise if there is an increase in the types of cancer-causing HPV not included in the vaccine.

"Catch-up" campaigns for women in their 20s, however, would not be cost-effective, the researchers said. They didn't calculate cost-effectiveness of vaccinating women ages 27 to 45, but a trend seems clear, said Jane Kim, the study's lead author.

Experts believe that the earlier a female is vaccinated, the better the odds she will avoid HPV-caused cervical disease, thus lowering healthcare costs down the road.

Women older than 26 can get the shot from their doctors. A woman may decide that getting vaccinated is worth it even if vaccinating everyone her age isn't considered cost-effective, some policy experts noted.